Work-Related Hand, Wrist, and Elbow Injuries and Conditions

Work-related musculoskeletal injuries and conditions affecting hands, wrists, and elbows account for most work-related worker compensation claims. Hand injuries account for 9% of all workers' compensation claims and makeup 19% of lost work claims. In 2010, the Bureau of Labor Statistics reported 154,060 injuries involving the hand or wrist and estimated that greater than 10% of all emergency room visits are related to hand and wrist injuries.

Work-related musculoskeletal injuries and conditions fall in two categories:​
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  1. ​​​​Acute or traumatic, which are due to accidents (i.e., lacerations, fractures, and amputations)
  2. Those that develop gradually (i.e., injuries resulting from overuse) ​

Risk factors for work-related injuries and conditions

Understanding the difference between the "cause" and the "risk factor is important." In the case of a traumatic injury at work, such as a wrist fracture from slipping on a wet surface, there is a clear reason for what caused the wrist fracture. It was the fall from slipping on the wet floor. Wet floors are a risk factor for falls; however, not everyone who falls suffers a wrist fracture or needs to see a doctor. Another example is repetitive keyboard use in patients who develop carpal tunnel syndrome. Keyboard use does not cause carpal tunnel syndrome; however, it is a risk factor for 1 in 20 individuals of the general population who may be predisposed to develop carpal tunnel syndrome due to genetics, female gender, or pregnancy.

The most common risk factors responsible for work-related injuries include:
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  • Fixed or constrained body positions
  • Continual repetition of movements
  • Force concentrated on small parts of the body (hand or wrist)
  • The quick pace of work does not allow sufficient recovery between movements
  • Heat and cold
  • Vibration

It is important to note that occupational hand and wrist injuries most commonly occur in workers with less than one year of experience during overtime work or after skipping breaks. Training and education regarding safety and ergonomics in new employees markedly decreases the occurrence of work-related injuries.
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Symptoms of work-related injuries and conditions

Pain is the hallmark of acute or traumatic work-related injuries requiring emergent care. On the other hand, work-related injuries that develop gradually may present with joint stiffness, muscle tightness, numbness and tingling, swelling, tenderness to the touch, or skin color changes - with or without pain. Since the onset of these symptoms is gradual, they may progress in stages from mild to severe.

  • Early-stage: symptoms occur during the work shift but disappear after work hours and during off days. There is no reduction in work performance.
  • Intermediate stage: symptoms occur early in the work shift and persist after work. There is reduced capacity for repetitive work.
  • Late-stage: symptoms persist, making it difficult to sleep at night and perform light work duties.

The earlier you recognize your symptoms and receive appropriate evaluation and treatment, the better your treatment outcome.